Browsing by Subject "Group psychotherapy"

Now showing 1 - 3 of 3
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    Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial
    (American Medical Association, 2022) Arntz, Arnoud; Jacob, Gitta A.; Lee, Christopher W.; Brand-de Wilde, Odette Manon; Fassbinder, Eva; Harper, R. Patrick; Lavender, Anna; Lockwood, George; Malogiannis, Ioannis A.; Ruths, Florian A.; Schweiger, Ulrich; Shaw, Ida A.; Zarbock, Gerhard; Farrell, Joan M.; Psychology, School of Science
    Importance: Schema therapy (ST), delivered either in an individual or group format, has been compared with other active treatments for borderline personality disorder (BPD). To our knowledge, the 2 formats have not been compared with treatment as usual (TAU) or with each other. Such comparisons help determine best treatment practices. Objective: To evaluate whether ST is more effectively delivered in a predominantly group or combined individual and group format and whether ST is more effective than optimal TAU for BPD. Design, setting, and participants: In this multicenter, 3-arm randomized clinical trial conducted at 15 sites in 5 countries (Australia, Germany, Greece, the Netherlands, and the UK), outpatients aged 18 to 65 years who had BPD were recruited between June 29, 2010, and May 18, 2016, to receive either predominantly group ST (PGST), combined individual and group ST (IGST), or optimal TAU. Data were analyzed from June 4, 2019, to December 29, 2021. Interventions: At each site, cohorts of 16 to 18 participants were randomized 1:1 to PGST vs TAU or IGST vs TAU. Both ST formats were delivered over 2 years, with 2 sessions per week in year 1 and the frequency gradually decreasing during year 2. Assessments were collected by blinded assessors. Main outcomes and measures: The primary outcome was the change in BPD severity over time, assessed with the Borderline Personality Disorder Severity Index (BPDSI) total score. Treatment retention was analyzed as a secondary outcome using generalized linear mixed model survival analysis. Results: Of 495 participants (mean [SD] age, 33.6 [9.4] years; 426 [86.2%] female), 246 (49.7%) received TAU, 125 (25.2%) received PGST, and 124 (25.0%) received IGST (1 of whom later withdrew consent). PGST and IGST combined were superior to TAU with regard to reduced BPD severity (Cohen d, 0.73; 95% CI, 0.29-1.18; P < .001). For this outcome, IGST was superior to TAU (Cohen d, 1.14; 95% CI, 0.57-1.71; P < .001) and PGST (Cohen d, 0.84; 95% CI, 0.09-1.59; P = .03), whereas PGST did not differ significantly from TAU (Cohen d, 0.30; 95% CI, -0.29 to 0.89; P = .32). Treatment retention was greater in the IGST arm than in the PGST (1 year: 0.82 vs 0.72; 2 years: 0.74 vs. 0.62) and TAU (1 year: 0.82 vs 0.73; 2 years: 0.74 vs 0.64) arms, and there was no significant difference between the TAU and PGST arms (1 year: 0.73 vs 0.72; 2 years: 0.64 vs 0.62). Conclusions and relevance: In this randomized clinical trial, IGST was more effective and had greater treatment retention compared with TAU and PGST. These findings suggest that IGST is the preferred ST format, with high retention and continuation of improvement in BPD severity after the completion of treatment.
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    Group-Based Metacognitive Reflection and Insight Therapy (MERITg) and Its Relationship to Recovery-Oriented Beliefs in Serious Mental Illness
    (MDPI, 2024-06-22) Musket, Christie W.; Bullock, Joshua; Fiszdon, Joanna M.; Stacy, Meaghan; Martino, Steve; James, Alison; Lysaker, Paul H.; Schnakenberg Martin, Ashley M.; Psychiatry, School of Medicine
    Group-based Metacognitive Reflection and Insight Therapy (MERITg) is the group application of Metacognitive Reflection and Insight Therapy (MERIT), an evidence-based, integrative, recovery-oriented intervention to enhance insight and understanding of oneself and others in individuals with serious mental illness (SMI). MERITg may offer therapeutic interactions between participants that uniquely support recovery. The goal of the current study was to examine the relationship between MERITg participation and recovery-oriented beliefs. Thirty-one participants (outpatient = 21; inpatient = 10) in SMI treatment programs participated in MERITg as an adjunctive treatment. A short form of the Maryland Assessment of Recovery in Serious Mental Illness (MARS-12) was used to assess recovery-oriented beliefs before and after group participation. Recovery-oriented beliefs significantly improved in the outpatient MERITg group but not in the inpatient group, and change in recovery-oriented beliefs was positively correlated with the total number of groups attended. These findings suggest the promise of MERITg for enhancing recovery-oriented beliefs. The potential role of treatment setting is discussed.
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    Translating an integrative metacognitive model of psychotherapy for serious mental illness into a group format: A pilot investigation on feasibility
    (American Psychological Association, 2024) Schnakenberg Martin, Ashley M.; Bullock, Joshua; Fiszdon, Joanna; Stacy, Meaghan; Martino, Steve; James, Alison V.; Wiesepape, Courtney; Lysaker, Paul H.; Psychiatry, School of Medicine
    Metacognitive Reflection and Insight Therapy (MERIT) is a one-on-one intervention that targets insight with the aim to help people with serious mental illness develop more integrated ideas about themselves and others in order to respond to their psychological and social challenges more adaptively. There is a growing body of evidence on MERIT’s effectiveness. Considering the clinical demand for more cost-effective group psychotherapies, we modified the original individual MERIT format to a group-based intervention (MERITg) for application in inpatient and outpatient psychiatric settings. Thirty-one participants (inpatient = 10; outpatient = 21) with serious mental illness were surveyed on their experience of MERITg, which was offered adjunctively to their routine clinical care. Program evaluation measures were used to assess feasibility and acceptance of the group. Across locations, more than half of all participants attended more than one group. Participants reported attending the group initially because they thought writing would be helpful, and further reported that they liked the group because they enjoyed writing and the discussion, and that they found it interesting to hear the perspectives and writings of others. Findings further support the need for future research on the efficacy and effectiveness of the group and its relationship to changes in metacognitive capacity and recovery.